﻿<!DOCTYPE HTML>
<html>
<head>
<title>新业务照会回复确认</title>
<style type="text/css">
body {
	font-family: "Microsoft YaHei";
	font-family: "Microsoft YaHei" !important;
	margin: 0;
	padding: 0;
	font-size: 14px;
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	background: url(../img/bg.jpg) #fff left top repeat-x;
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  position: relative;
  float: left;
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}
textarea.form-control {
  height: auto;
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}
</style>
</head>

<body>
    

<!--内容区域 start-->
<div class="H_top_bot">
<table width="100%">
      <tbody>
        <tr>
          <td align="left" valign="middle">
            <img src="logo-a.png" width="30%">
          </td>
          <td align="right" valign="middle">
            <img src="logo-b.png" class="" width="20%">
          </td>
        </tr>
      </tbody>
    </table>
  <div class="padding-2">  
    <div class="blank-2"></div>
    <h3 class="text-center b">新业务照会回复确认书</h3>
    <div class="blank-2"></div>
    <div class="form-group">
      <label class="col-md-1 control-label no-margin">保单号:</label>
      <div class="col-md-4"><p class="form-control-static blue">123456789112</p></div>
      <label class="col-md-2 control-label no-margin">主险名称:</label>
      <div class="col-md-3"><p class="form-control-static blue">安联超级随心两全保险（分红型）</p></div>
      <div class="clearfix"></div>
    </div>
    <hr>
    <div class="blank-1"></div>
    <p id="one" class="font-18 lh-45">1.签署了一份声明</p>
    <p id="two" class="form-control"  placeholder="无法提供近三年的收入凭证。">苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友苏 来友苏来友苏来友苏来友 苏来友苏 来友苏来友苏来友苏来友苏来友苏来友苏来友苏来友</p>
    <p class="font-18 lh-45">2.补充了证件类资料5张</p>
    <p class="font-18 lh-45">3.补充了财务类资料5张</p>
    <p class="font-18 lh-45">4.补充了医疗类资料2张</p>
    <!--  -->
    <div class="blank-5"></div>
    <p class="font-18 lh-45 p-2em b">本照会所要求的内容是保险合同的组成部分，为使您的利益得到有效保证，敬请您在本照会书上亲自签名，且  请您在收到本通知书后及时给予反馈。</p>
    <!--  -->
    <div class="blank-1"></div>
    <div class="form-group">
      <label class="col-md-2 control-label">投保人签字</label>
      <label class="col-md-2 lh-45">xxx</label>
      <label class="col-md-3 control-label">营销人员签字</label>
      <label class="col-md-2 lh-45">dddd</label>
      <div class="blank-10"></div>
    </div>
    <div class="blank-2"></div>
    <p class="text-right">2001-01-21</p>
  </div>    
</div>
<!--内容区域 end-->

</body>
</html>
